Golden Rice, VAD, Covid and Public Health: Saving Lives and Money

On July 21, 2021, Golden Rice was registered in the Philippines allowing cultivation and consumption. Research, as an intervention to combat vitamin A deficiency (VAD), started in 1991, and proof of concept for what was to become Golden Rice, was achieved in 1999. In the 1990s, 23–34% deaths globally of children less than 5 years old were caused by VAD, and in developing countries, the percentage was even higher. By 2013, progress against the Millennium Development Goals had reduced <5-y child deaths globally from VAD to about 2% of all such deaths. The progress included significant vaccination programs against measles, and better access to clean water, as well as vitamin A supplementation, all delivered through community health programs. Economic development and education about diet reduced food insecurity. In contrast to continuing VAD deaths, the Covid-19 pandemic has attracted huge political attention, including in low- and middle-income countries. Community health programs have been adversely affected by the pandemic. There is a danger that as a result VAD rates, child and maternal mortality climbs again toward 1990’s levels. Adoption of Golden Rice provides a safe, culturally simple amelioration and is costless. Other countries should seize the opportunity. Bangladesh is first in line, possibly followed by Indonesia and India.

Diagnosis of Taenia solium infections based on “mail order” RNA-sequencing of single tapeworm egg isolates from stool samples

Combined community health programs aiming at health education, preventive anti-parasitic chemotherapy, and vaccination of pigs have proven their potential to regionally reduce and even eliminate Taenia solium infections that are associated with a high risk of neurological disease through ingestion of T. solium eggs. Yet it remains challenging to target T. solium endemic regions precisely or to make exact diagnoses in individual patients. One major reason is that the widely available stool microscopy may identify Taenia ssp. eggs in stool samples as such, but fails to distinguish between invasive (T. solium) and less invasive Taenia (T. saginata, T. asiatica, and T. hydatigena) species. The identification of Taenia ssp. eggs in routine stool samples often prompts a time-consuming and frequently unsuccessful epidemiologic workup in remote villages far away from a diagnostic laboratory. Here we present “mail order” single egg RNA-sequencing, a new method allowing the identification of the exact Taenia ssp. based on a few eggs found in routine diagnostic stool samples. We provide first T. solium transcriptome data, which show extremely high mitochondrial DNA (mtDNA) transcript counts that can be used for subspecies classification. “Mail order” RNA-sequencing can be administered by health personnel equipped with basic laboratory tools such as a microscope, a Bunsen burner, and access to an international post office for shipment of samples to a next generation sequencing facility. Our suggested workflow combines traditional stool microscopy, RNA-extraction from single Taenia eggs with mitochondrial RNA-sequencing, followed by bioinformatic processing with a basic laptop computer. The workflow could help to better target preventive healthcare measures and improve diagnostic specificity in individual patients based on incidental findings of Taenia ssp. eggs in diagnostic laboratories with limited resources.

Changes in Adherence to the 24-Hour Movement Guidelines and Overweight and Obesity among Children in Northeastern Japan: A Longitudinal Study before and during the COVID-19 Pandemic

There are few studies comparing adherence to Canadian 24-hour Movement Guidelines (24-h MG) before and during the COVID-19 pandemic and exploring the pandemic’s effect on childhood obesity. This survey-based 2-year study investigated changes in obesity and adherence to the 24-h MG in children before and during the COVID-19 pandemic. Data were collected at two points in time: pre-COVID-19 (May 2019; T1; n = 247) and during-COVID-19 (May 2021; T2; n = 171). Participants were healthy elementary school children aged between 6–12 years in northeastern Japan. The questionnaire comprised items on physical activity, screen time, sleep duration, adherence to the 24-h MG, and anthropometric and demographic characteristics. Among all participants, a statistically significant difference (p < 0.001) between the average body mass index at T1 (M = 16.06 kg/m2, SD = 2.08 kg/m2) and T2 (M = 18.01 kg/m2, SD = 3.21 kg/m2) was observed, where 17.8% were overweight and obese at T1 and 24% at T2, and 10.9% adhered to all 24 h MG at T1 and 4.1% at T2. To prevent obesity in children during the COVID-19 pandemic, environmental changes should be evaluated and appropriate preventive measures taken, including pro-community health programs that encourage parent-children outdoor activities.

Knowledge Attitude and Practices in Community Health Programs by the Pharmacists in Lahore, Pakistan

Introduction: A public health program intends to improve the health care services in society to lessen the disease burden particularly in the case of non-infectious diseases. This research work investigates the knowledge, practice, and attitude of pharmacists in community health programs offered by the government concerning their demographic associates. Methods: A cross-sectional survey from 75 registered pharmacists is conducted in Lahore, Pakistan to explore the role of pharmacists in public health programs by using a self-administered questionnaire from January 01, 2021, to January 15, 2021. The collected data is analyzed through frequencies, percentages, and a chi-square test of association. Results: Most of the pharmacists were in favor that the disease burden can be reduced by indulging pharmacists in public health programs. Many pharmacists already working on public health issues were screening of the blood glucose, blood pressure, obesity, hypertension, dyslipidemia, and smoking cessation. Conclusion: Like many other countries, Pakistan may also effectively accomplish its public health goals by offering training to the pharmacists and retaining them in public health programs at the pharmacy level.

Sadie Heath Cabaniss and Professional School Nursing: Strategic Foundations to Promote Population Health

School nursing began in New York City, and extended to the southern city of Richmond, Virginia from 1900-1920. Nurse leaders, including Virginia’s Sadie Heath Cabaniss, initiated and replicated community health programs to form and extend the early school nurse movement. This article describes the efforts of Cabaniss and her mentors, based on traditional historical research methods via a social history framework that included examination of numerous primary sources. Cabaniss often crossed lines of geography and culture to establish the Nurses’ Settlement of Richmond and impact school nursing in Richmond. Our analysis and discussion demonstrates that these leaders forged powerful alliances through which they established effective programs of public health. We introduce a framework of four synergistic concepts, the C.A.R.E. Model of Successful Nursing Initiatives. This model reflects the dynamic strategic approaches of collaboration, advocacy, research, and education that Cabaniss and her colleagues used successfully to impact population health through school nursing and considers the potential of the application for nurses of today.

Community health programs delivered through information and communications technology in high-income countries: a scoping review (Preprint)

BACKGROUND The COVID-19 pandemic has required a widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms, has introduced new challenges. OBJECTIVE The purpose of this review was to scope for ICT-delivered health programs implemented within the community health setting in high income countries, and rapidly disseminate findings to health professionals. METHODS The Joanna Briggs Institute’s (JBI) scoping review methodology guided the review of literature. RESULTS The search retrieved 7110 unique citations. Each title and abstract were screened by at least two reviewers, resulting in 399 citations for full text review. Of these, 73 citations were included. An additional 27 citations were identified through reviewing reference lists of included studies resulting in 100 citations. Citations examined 84 ICT-delivered programs from 20 high-income countries. Variations in program design, ICT platforms, research design and outcomes were evident. CONCLUSIONS Included programs and research were heterogenous, addressing prevalent chronic diseases. Evidence was retrieved for the effectiveness of nurse and allied health ICT-delivered programs. Findings indicated that outcomes for participants receiving ICT-delivered programs, when compared to participants receiving face-to-face programs, were either equivalent or better. Gaps included a paucity of co-designed programs, qualitative research around group programs, programs for patients and carers, and evaluation of cost-effectiveness. During COVID-19 and beyond, health professionals in the community health setting are encouraged to build on existing knowledge and address evidence gaps by developing and evaluating innovative ICT-delivered programs in collaboration with consumers and carers.

Geographic Barriers to Achieving Universal Health Coverage in a rural district of Madagascar

Poor geographic access can persist even when affordable and well-functioning health systems are in place, limiting efforts for universal health coverage (UHC). It is unclear how health facilities and community health workers contribute to achieving UHC. Using geographic information from thousands of patients in a rural district of Madagascar we evaluate how a health system strengthening (HSS) intervention aimed towards UHC affects the geography of primary care access. We find that facility-based interventions (user-fee exemptions, improved readiness) achieved high utilization rates only among populations who lived in close proximity to supported facilities. Scaling only facility-based HSS programs across the district would result in large gaps in health care access for the majority of the population. Community health provided major improvements in service utilization for children regardless of their distance from facilities. Our results have implications for UHC policies and suggest that greater emphasis on professionalized community health programs is essential.

Role of Female Community Health Volunteers for Prevention and Control of COVID-19 in Nepal

Female Community Health Volunteers (FCHVs) are the pillars of community health programs in Nepal who play a pivotal role in implementing various community based preventive, promotive, and curative health programs. In the context of COVID 19 pandemic and possible outbreak in Nepal, the only way by which it can be stopped at the moment is by prevention. This paper presents the role of FCHVs for the prevention and control of COVID 19 in Nepal.